2015 Employer Health Benefits Survey

Section Six: Worker and Employer Contributions for Premiums

Premium contributions by covered workers average 18% for single coverage and 29% for family coverage.1 The average monthly worker contributions are $89 for single coverage ($1,071 annually) and $413 for family coverage ($4,955 annually). On average, covered workers contribute the same percentage of the premium in 2015 as they did in 2014 for both single and family coverage. There continue to be important differences by firm size and other firm characteristics: covered workers in small firms (3-199 workers) contribute a lower percentage of the premium for single coverage (15% vs. 19%) but a much higher percentage of the premium for family coverage than covered workers in large firms (200 or more employees) (36% vs. 26%).

In 2015, covered workers on average contribute 18% of the premium for single coverage and 29% of the premium for family coverage, the same percentages reported in both 2014 and 2013 (Exhibit 6.1). These contributions have remained stable since 2010 for both single and family coverage.

On average, workers with single coverage contribute $89 per month ($1,071 annually), and workers with family coverage contribute $413 per month ($4,955 annually) towards their health insurance premiums. Both are similar to the amounts reported in 2014 (Exhibit 6.2), (Exhibit 6.3), and (Exhibit 6.4).

The average worker contribution in HDHP/SOs is lower than the overall average worker contributions for single coverage ($868 vs. $1,071) and family coverage ($3,917 vs. $4,955) (Exhibit 6.5).

In addition to differences between plan types, there are differences in worker contributions by type of firm. As in previous years, workers in small firms (3-199 workers) contribute a lower amount annually for single coverage than workers in large firms (200 or more workers) ($899 vs. $1,146). In contrast, workers in small firms with family coverage contribute significantly more annually than workers in large firms ($5,904 vs. $4,549) (Exhibit 6.8).

The average family contribution for covered workers enrolled in small firms is less than the average family contribution at large firms within each plan type (Exhibit 6.10).

The average worker contribution for single coverage is similar to last year for both small firms (3-199 workers) and large firms (Exhibit 6.6) and (Exhibit 6.7).

Variation in Worker Contributions to the Premium

There is a great deal of variation in worker contributions to premiums.

Twenty-nine percent of covered workers contribute $1,500 or more annually (140% or more of the average worker contribution) for single coverage, while 15% of covered workers have an annual worker contribution of less than $643 (less than 60% of the average worker contribution) (Exhibit 6.15).

For family coverage, 21% of covered workers contribute $6,936 or more annually (140% or more of the average worker contribution), while 20% of covered workers have an annual worker contribution of less than $2,973 (less than 60% of the average worker contribution) (Exhibit 6.15).

The majority of covered workers are employed by a firm that contributes at least half of the premium for single and family coverage.

Sixteen percent of covered workers with single coverage and 6% of covered workers with family coverage work for a firm that pays 100% of the premium (Exhibit 6.16).

Covered workers in small firms (3-199 workers) are more likely to work for a firm that pays 100% of the premium for single coverage than workers in large firms (200 or more workers). Thirty-five percent of covered workers in small firms have an employer that pays the full premium for single coverage, compared to 7% of covered workers in large firms (Exhibit 6.17). For family coverage, 16% of covered workers in small firms have an employer that pays the full premium, compared to 1% of covered workers in large firms (Exhibit 6.18).

Three percent of covered workers in small firms (3-199 workers) and 2% of covered workers in large firms (200 or more workers) contribute more than 50% of the premium for single coverage (Exhibit 6.17). For family coverage, 32% of covered workers in small firms work in a firm where they must contribute more than 50% of the premium, compared to 8% of covered workers in large firms (Exhibit 6.18).

Differences by Firm Characteristics

The percentage of the premium paid by covered workers varies by several firm characteristics.

For family coverage, covered workers in firms with many lower-wage workers (35% or more earn $23,000 or less annually) contribute a greater percentage of the premium than those in firms with fewer lower-wage workers (41% vs. 28%) (Exhibit 6.21). Covered workers in firms with many higher-wage workers (35% or more earn $58,000 or more a year) contribute less on average than those in firms with a lower proportion of higher-wage workers (26% vs. 33%).

Twenty-nine percent of covered workers at firms with many lower-wage workers pay more than 50% of the premium for family coverage, in contrast to 14% at firms with fewer lower-wage workers (Exhibit 6.19).

Looking at dollar amounts, covered workers in firms with many lower-wage workers (35% or more earn $23,000 or less annually) on average contribute $6,382 for family coverage versus $4,829 for covered workers in firms with fewer lower-wage workers (Exhibit 6.13).

Covered workers with family coverage in firms that have at least some union workers contribute a significantly lower percentage of the premium than those in firms without any unionized workers (23% vs. 32%) (Exhibit 6.21).

For workers with family coverage in large firms (200 or more workers), the average percentage contribution for workers in firms that are partially or completely self-funded is lower than the average percentage contributions for workers in firms that are fully insured (25% vs. 32%) (Exhibit 6.21). 2

Covered workers in private for profit firms contribute a significantly higher percentage of the premium for single coverage (19%) than do workers in private not-for-profit firms (16%) and public organizations such as state or local governments (12%) (Exhibit 6.20).

Contribution Approaches

Among firms offering health benefits with fewer than 20 employees, 12% contribute different dollar amounts toward premiums for different employees (Exhibit 6.26). Employers may contribute different amounts to different employees based on a variety of reasons, including workers’ age, smoking status, seniority, job title or location.

Among small firms (3-199 workers) offering health benefits, 45% indicate that they contribute the same dollar amount for single coverage as family coverage. In contrast, over a third (35%) of small firms report that they contribute a higher dollar amount for workers enrolled in family coverage than in single coverage (Exhibit 6.27).

Changes over Time

The amount that workers contribute to single coverage premiums has increased 76% since 2005 and 19% since 2010. Covered workers’ contributions to family coverage have increased 83% since 2005 and 24% since 2010. Over the last five years, the average worker contributions for single and family coverage have risen at a similar rate.

Over the last ten years, the average employer contribution to both single coverage and family coverage premiums has risen faster than the average employee contribution.

Over the last ten years, the average worker contribution for family coverage has risen at a similar rate for large firms (200 or more workers) and small firms (83% and 86% respectively).

The average worker contribution for family coverage has risen at a similar rate for firms with many lower-wage workers (35% or more earn $23,000 or less annually) and those with fewer lower-wage workers over the past ten years (86% and 80%, respectively).

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Section Six: Worker and Employer Contributions for Premiums

exhibits

Average Percentage of Premium Paid by Covered Workers for Single and Family Coverage, 1999-2015

Download Exhibit 6.1

Average Monthly Worker Premium Contributions Paid by Covered Workers for Single and Family Coverage, 1999-2015

Download Exhibit 6.2

Average Annual Worker and Employer Contributions to Premiums and Total Premiums for Single Coverage, 1999-2015

Download Exhibit 6.3

Average Annual Worker and Employer Contributions to Premiums and Total Premiums for Family Coverage, 1999-2015

Download Exhibit 6.4

Average Annual Firm and Worker Premium Contributions and Total Premiums for Covered Workers for Single and Family Coverage, by Plan Type, 2015

Download Exhibit 6.5

Average Annual Worker Contributions for Covered Workers with Single Coverage, by Firm Size, 1999-2015

Download Exhibit 6.6

Average Annual Worker Contributions for Covered Workers with Family Coverage, by Firm Size, 1999-2015

Download Exhibit 6.7

Average Annual Worker Premium Contributions Paid by Covered Workers for Single and Family Coverage, by Firm Size, 1999-2015

Download Exhibit 6.8

Average Annual Firm and Worker Premium Contributions and Total Premiums for Covered Workers for Single Coverage, by Plan Type and Firm Size, 2015

Download Exhibit 6.9

Average Annual Firm and Worker Premium Contributions and Total Premiums for Covered Workers for Family Coverage, by Plan Type and Firm Size, 2015

Download Exhibit 6.10

Average Monthly and Annual Worker Premium Contributions Paid by Covered Workers for Single and Family Coverage, by Plan Type and Firm Size, 2015

Download Exhibit 6.11

Average Monthly and Annual Worker Premium Contributions Paid by Covered Workers for Single and Family Coverage, by Plan Type and Region, 2015

Download Exhibit 6.12

Average Premium Contribution Paid by Covered Workers for Single and Family Coverage, by Firm Characteristics, 2015

Download Exhibit 6.13

Average Monthly Worker Premium Contributions Paid by Covered Workers for Single and Family Coverage, by Plan Type, 1999-2015

Download Exhibit 6.14

Distribution of Worker Premium Contributions for Single and Family Coverage Relative to the Average Annual Worker Premium Contribution, 2015

Download Exhibit 6.15

Distribution of Percentage of Premium Paid by Covered Workers for Single and Family Coverage, 2002-2015

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Distribution of Percentage of Premium Paid by Covered Workers for Single Coverage, by Firm Size, 2002-2015

Download Exhibit 6.17

Distribution of Percentage of Premium Paid by Covered Workers for Family Coverage, by Firm Size, 2002-2015

Download Exhibit 6.18

Distribution of the Percentage of Total Premium Paid by Covered Workers for Single and Family Coverage, by Firm Wage Level, 2015

Download Exhibit 6.19

Average Percentage of Premium Paid by Covered Workers for Single Coverage, by Firm Characteristics and Size, 2015

Download Exhibit 6.20

Average Percentage of Premium Paid by Covered Workers for Family Coverage, by Firm Characteristics and Size, 2015

Download Exhibit 6.21

Average Percentage of Premium Paid by Covered Workers for Single and Family Coverage, by Plan Type and Firm Size, 2015

Download Exhibit 6.22

Average Percentage of Premium Paid by Covered Workers for Single and Family Coverage, by Plan Type, 1999-2015

Download Exhibit 6.23

Average Percentage of Premium Paid by Covered Workers for Single and Family Coverage, by Plan Type and Region, 2015

Download Exhibit 6.24

Average Percentage of Premium Paid by Covered Workers, by Plan Type and Industry, 2015

Download Exhibit 6.25

Among Firms Offering Health Benefits with Fewer Than 20 Employees, Variations in Premiums and Firm Premium Contributions for Single Coverage, 2015

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Among Firms Offering Family Coverage, Percentage of Employers Using Various Approaches to Family Premium Contributions, by Firm Size and Region, 2015

Download Exhibit 6.27

Average Annual Worker Contributions for Covered Workers with Family Coverage, by Income Level, 1999-2015

Download Exhibit 6.28

Average Annual Worker and Employer Contributions to Premiums and Total Premiums for Single and Family Coverage, by Firm Size, 2015

Download Exhibit 6.29

Average Annual Worker and Employer Contributions to Premiums and Total Premiums for Single and Family Coverage, by Firm Wage Level, 2015